Obstetric emergencies simulation-based training in Ob/Gyn residency: A nationwide survey

To provide a comprehensive nationwide overview of simulation-based training on obstetric emergencies during residency.

A cross-sectional study surveyed Ob/Gyn residents in Portugal in 2023, using a self-designed questionnaire on simulation-based training. A snowball sampling method was used, and analysis included descriptive statistics with comparisons using χ² or Fisher exact test (P < 0.05).

A total of 97 residents participated (33.6% of the Portuguese residents). Participants dedicated an average (± standard deviation) of 13.8 h (± 11.3 h) to simulation-based training. Commonest (>90%) trained scenarios were eutocic delivery, vacuum and forceps extraction, and breech delivery. Underrepresented scenarios (<5%) were cesarean with impacted fetal head, disseminated intravascular coagulation, amniotic fluid embolism, and polytrauma in pregnancy. Less than 10% of residents experienced real-life retention of the after-coming head, amniotic fluid embolism, maternal cardiac arrest, maternal anaphylaxis, and polytrauma in pregnancy. Senior residents reported more frequent training in complex scenarios. Identified flaws in clinical practice were unfamiliarity with emergency guidelines, poor technical skills, and lack of teamwork strategies.

Based on nationwide data, critical gaps in simulation-based training for obstetric emergencies in Ob/Gyn residency programs were identified, and the authors propose strategies to improve training.